Aging Well: Improving older adults' oral health

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For tips about good oral health for people of all ages, visit www.beasmartmouth... or ww.cdc.gov/oral health.

There is good news and bad news when it comes to older adults' oral health.

Although more adults are keeping their teeth into old age, their physical, cognitive and financial problems can make it incredibly difficult for them to ward off oral decay and disease.

"The biggest problem with the elderly is, they basically outlive their teeth," said Gary Fresques, a dentist in Steamboat Springs who performs dental work on residents at The Doak Walker Care Center.

He explained that even people with healthy, well-maintained teeth and gums likely will need to have old dental work, such as fillings and crowns, replaced after age 50. As they age, illnesses can make oral maintenance difficult, and without the help of others, oral hygiene easily falls by the wayside.

"Without exception, every (older) patient that comes in my office has tons of food and debris stuck in their teeth ... and have rampant decay - it's sad," Fresques said.

Oral health problems in older adults can have a profound effect on a person's overall health and quality of life. Dental disease can be painful, prevent a person from enjoying food and eating nutritiously and also affect their ability to laugh, smile, talk and be social.

Researchers also suspect links between periodontitis, or advanced gum disease, and other serious health problems such as cardiovascular disease, stroke and bacterial pneumonia. People with conditions such as diabetes, HIV and AIDS may also be at higher risk for developing severe periodontal disease.

Older Americans' oral health is not being ignored. Organizations such as Oral Health Awareness Colorado!, a coalition of advocacy groups, state agencies and other interested parties, is working to spread awareness of the issue, provide education resources and broaden access to dental care for low-income people of all ages - perhaps the biggest hurdle.

The organization's goal in the next year is to have adult dental benefits added to Medicaid in Colorado. The economic downturn may slow the process, but strong support from Governor Ritter and other groups will help make the goal attainable in the near future, said Deborah Colburn, managing director of OHAC!

"We're not going to go away until it's in place," she said.

Oral health problems

As national dialogue continues on improving older adults' oral health, individuals can help themselves and those they care for by learning about common oral problems and preventative practices.

Two of the most common oral conditions are dental carries or cavities and periodontal (gum) disease.

Nearly one-third of adults 65 and older have untreated tooth decay, according to the U.S. Centers for Disease Control, which recommends using a fluoride toothpaste and drinking fluoridated water to help reduce and prevent cavities.

There is some public concern about potential health effects of consuming certain levels of fluoride. For research and other information related to this, visit www.ada.org. Click on "A-Z topics" and "Fluoride & Fluoridation."

Bacterial plague can cause inflammation of the gums or gingivitis, the mildest of periodontal diseases. Good oral hygiene, including brushing, flossing and visiting a dentist to have hard plaque deposits or tartar removed, can prevent or reverse gingivitis. If left untreated, however, gingivitis can lead to infection of the tissue and bone that support the teeth, and ultimately tooth loss.

Mouth and throat cancers, though not prevalent, also are a concern, particularly among older adults. About 28,000 Americans are diagnosed with oral cancers involving the mouth, tongue, lips and pharynx each year, according to the CDC.

Most people diagnosed with oral cancer are older than 60 and have a history of tobacco use and heavy alcohol consumption. Cigarette smoking also can complicate tooth decay, gum disease and dental procedures.

Regular dental exams are important for catching oral cancer early. Once a person feels pain related to oral cancer, the disease usually has progressed to an advanced stage.

Risk factors and limitations

Many older adults experience dry mouth or a lack of saliva which helps protect tissues in the mouth and rebuilds tooth enamel. Dry mouth can make it difficult to chew, speak, swallow or wear dentures.

Many common medications - including antihistamines, diuretics and antidepressants - can cause dry mouth. Some medical treatments, such as chemotherapy, also can reduce saliva.

There are medications to help improve saliva production, and fluoride rinses can provide extra protection against tooth decay in people with dry mouth.

Physical limitations associated with arthritis and other conditions make it harder to brush and floss teeth. Electric toothbrushes, toothbrushes with larger handles and other adaptive techniques can make these tasks easier.

Many elderly people, however, depend on caregivers at home or at long-term care facilities for their daily oral care. This can be a tough on caregivers, who may not have the training to give proper care and identify problems or the persistence to provide care to patients who complain.

Perhaps the biggest problem leading to poor oral health in older adults is a lack of funds for routine dental exams and procedures. Older adults who have dental insurance usually lose it once they retire. Medicare does not cover routine dental services, and Medicaid, when available, often is limited in what it covers.

That leaves many older adults to pay for services out of pocket or forgo them altogether because of a lack of funds.

Some help is available for low-income older adults in Colorado through the state's Dental Assistance Program for Seniors. Residents who receive Old Age Pension public assistance qualify for help with dentures and repair, tooth extractions, exams and x-rays, fillings and cleanings. For more information, call 303-692-3652.

<p>This article contains information from the American Society on Aging at www.asaging.org and "The Oral Health of Older Americans," a report from the CDC.</p>